PURPOSE OF REVIEW: To review and prioritize data on pediatric cardiac pacing published during the period of the last 18 months. RECENT FINDINGS: New approaches to preservation of ventricular function in pediatric pacing are based on recent publications confirming major influence of the ventricular pacing site on left ventricular (LV) function and synchrony. Current studies on epicardial vs. transvenous pacing continue to show survival superiority of endocardial leads. Long-term outcome of epicardial pacing may, however, be positively influenced by technical refinements. Recent amendments of the guidelines for cardiac resynchronization therapy (CRT) in adult idiopathic and ischemic cardiomyopathy are likely to influence CRT indications in children. Novel data give interesting insights into implantable cardioverter-defibrillator (ICD) lead survival as well as the use of ICDs in young patients with hypertrophic cardiomyopathy. SUMMARY: Pediatric cardiac pacing and ICD therapy is still a developing field likely to improve with technical refinements, proper lead placement and more specific therapy indications. The current review will give the reader information about recent developments and directions for the future.

Children's Heart Centre University Hospital Motol Prague Czech Republic

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